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Exam 16: Basics of Health Insurance

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Question 1

Multiple Choice

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A policy that covers a number of people under a single master contract issued to the employer or to an association with which they are affiliated and that is not self-funded is usually called

A) group policy.
B) individual policy.
C) a government plan.
D) a self-insured plan.

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Question 2

Multiple Choice

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Which of the following is not an advantage of managed care?

A) Healthcare costs are usually contained.
B) Access to specialized care and referrals is limited.
C) Most preventive medical treatment is covered.
D) Out-of-pocket expenses tend to be less than traditional insurance.

Correct Answer

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B

Question 3

Multiple Choice

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The medical assistant should always verify which of the following prior to the patient's appointment?

The maximum amount of money third-party payers will pay for a specific procedure or service is called the

Organizations that fund their own insurance programs offer their employees

The physician who enters into a contract with an insurance company and agrees to certain rules and regulations is called a ______ provider.

Veterans of the U.S.armed forces may be covered by

Employee-sponsored group policies usually provide greater benefits at lower premiums because of the large pool of people from whom premiums are collected.However,these employee-sponsored group health insurance plans offer limited benefits,and healthcare access is limited to healthcare providers that are contracted with them.

Which of the following plans require healthcare providers to become participating providers?

Which of the following are not reviewed by a utilization review committee?

A type of insurance that protects workers from loss of wages after an industrial accident that happened on the job is called

If Mr.Jones's insurance has a $500 deductible and a $50 surgery co-pay and then pays 80% of the charges,how much will his policy pay on his bill of $4,359?

A payment method in which providers are paid for each individual enrolled in a plan,regardless of whether the person sees the provider that month,is called a ______ plan.

Medigap polices cover which of the following?

Which of the following individuals would not normally be eligible for Medicare?

Dependents of military personnel are covered by which of the following government-sponsored health insurance plans?

If Mr.Jones's insurance has a $500 deductible and a $50 surgery co-pay,how much will his insurance pay on his bill of $4,359?

Under which of the following Medicare plans for primary care and specialists' services is the patient required to pay a monthly premium?

Most of today's health insurance policies cover which of the following?

Which part of Medicare covers prescription drug services?